High Blood Pressure Medicine and ED


I've got high blood pressure. Most of the medication that my doctor has prescribed keeps me from having proper erections. Right now, I've been on Ismelin (guanethidine) for a long time. Are there any lifestyle changes I can make so I can have a proper sex life with my partner?


By Dr. Owens at Sexualhealth.com

Erections are caused by increased blood flow to the penis. Medications against high blood pressure act by lowering the blood pressure in the entire body, also affecting the blood supply to the penis. Therefore it often becomes difficult for men taking this type of medication to achieve the increased blood flow necessary for having proper erections.

A good resource book for various medications' sexual side effects is Sexual Pharmacology. Drugs That Affect Sexual Function by Crenshaw & Goldberg (1996). Sexual side effects of guanethidine include impaired erectile function. Preferable alternatives are prazosin or similar alpha1blockers, calcium blockers and ACE inhibitors. I would suggest discussing these options with your physician, if you have not yet tried any of those medications. Do not change your current medication or dose without your doctor's consent!

The most important lifestyle changes for you would be to try to reduce your blood pressure through dietary changes (less sodium intake), weight loss, exercise and stress reduction in order to be less dependent on medication. However, you may already have exhausted these possibilities since it is usually recommended that you attempt a reduction in blood pressure through such measures at the beginning of treatment.

Also, avoid alcohol and cigarettes since both of these may affect erections negatively. Finally, you may be able to embrace a change in the way you think about what "proper sex with your partner" means. I recommend this to many of my clients, regardless of age or gender, since it has the potential of improving your sex life. Many couples learn that they can have great sex without an erect penis, and they find that oral or manual stimulation of the genitals or the involvement of sexual aids such as vibrators work just as well. Try to be inventive with respect to what type of sexual interaction you and your partner might enjoy. Your imagination is the only limiting factor.